A variety of situations arise in modem health care when it is required to maintain or improve a supine patient's airway without intubation. Such situations are common, for example, when transporting a partially or completely anesthetized supine patient to or from surgery. Other similar situations may arise in the emergency room, or in the recovery room after surgery. In such situations, intubation may not be desirable or even feasible due to the physical condition of the patient. Without intubation, however, several mechanisms can work to occlude the supine patient's airway, such as the pharynx collapsing, the tongue falling back into the throat, or the jaw simply falling back.
Up until now, health care professionals have countered these effects by using a procedure whereby the thumbs are placed on the patient's forehead and the fingers are placed behind the angles of the patient's jaw. When the health care professional rotates the wrist and pushes the fingers forward, the effect is to thrust the patient's jaw anteriorly. With the jaw in this artificial anterior position, the patient's airway is dramatically improved without intubation. The problem, however, is that this position with the hands now has to be maintained, disabling the health care professional from any other activity that requires use of the hands, and causing fatigue in hands and wrists of the health care professional.
The present invention is directed to an apparatus and a method that addresses this problem. A frame (with detachable pillow) is placed under the supine patient's head, secured to the patient's forehead if desired. Extensions attached to the frame emerge from under the back of the neck and run just above and parallel to the shoulders. Swinging members, pivoting about the far ends of the extensions, are then brought back towards the sides of the patient's neck, allowing jaw support members slidably attached to the ends of the swinging members to extend up under the angles of the patient's jaw.
Copying the effect of the health care professional's fingers when improving the airway as described above, the jaw support members are slid away from the frame, making contact with the angles of the patient's jaw and forcing the patient's jaw to be thrust forward anteriorly.
The slidable attachment of the jaw support members to the swinging members also includes a unidirectional clutch such as a ratchet and pawl system. Once the patient's jaw is thrust anteriorly to the position required to maintain or improve the airway, therefore, the unidirectional clutch keeps the jaw in this position until the clutch is released. At that time, if desired, the patient's head may then be tilted forward and the present invention removed.
Emergency removal of the present invention from the vicinity of the patient may also be accomplished by rotating the swinging members away from the patient until the jaw support members are clear. The patient's head may then be lifted momentarily and the entire apparatus removed quickly.
Related devices directed to supporting the human jaw from its angles are known in the field of undertaking. Morticians have patented devices intended to improve the appearance of supine corpses by modifying the position of the jaw with respect to the head. See, e.g., Stenshoel, U.S. Pat. No. 1,776,167; Hanson, U.S. Pat. No. 2,270,588. These devices do not solve the basic need addressed by the present invention, however, in that they are not directed to thrusting a patient's jaw anteriorly to maintain or improve the airway. Moreover, these devices are intended to hold the jaw semi-permanently for long periods, whereas the present invention fulfills a need to release the jaw quickly if necessary in an emergency.